Sylora J A, Gonzalez R, Vaughn M, Reinberg Y
Children's Health Care-Minneapolis, Minnesota, USA.
J Urol. 1997 Jan;157(1):48-50.
Neurogenic bladder due to cervical spinal cord injury is often best managed by clean intermittent catheterization. Limited upper extremity function makes patients with quadriplegia dependent on caregivers for clean intermittent catheterization. The Mitrofanoff umbilical appendicovesicostomy provides easy access to the bladder in patients with all types of access difficulty. We evaluated the Mitrofanoff umbilical appendicovesicostomy in 7 patients with quadriplegia.
Four men and 3 women with cervical spinal cord injury underwent the Mitrofanoff umbilical appendicovesicostomy with appendix (5) or ileum (2).
All patients are continent and able to self-catheterize via the umbilical stoma. In 1 patient with an ileal Mitrofanoff umbilical appendicovesicostomy umbilical incontinence was repaired surgically and stomal stenosis developed in 1, which required stomal revision. All patients use the stoma regularly. Four patients have moved out of care facilities and are living more independently.
The Mitrofanoff catheterizable channel is a valuable option for bladder management in patients with quadriplegia. Clean intermittent self-catheterization allows these patients independent function and facilitates their return to productive lives outside care facilities.
颈髓损伤所致神经源性膀胱通常采用清洁间歇性导尿术进行最佳管理。上肢功能受限使四肢瘫痪患者在进行清洁间歇性导尿时依赖护理人员。米氏脐尿管膀胱造口术为各种存在导尿困难的患者提供了便捷的膀胱导尿途径。我们对7例四肢瘫痪患者进行了米氏脐尿管膀胱造口术评估。
4例男性和3例女性颈髓损伤患者接受了带阑尾（5例）或回肠（2例）的米氏脐尿管膀胱造口术。
所有患者均能自主排尿，且能够通过脐部造口自行导尿。1例采用回肠米氏脐尿管膀胱造口术的患者出现脐部尿失禁，经手术修复；1例出现造口狭窄，需要进行造口修复。所有患者均定期使用造口。4例患者已搬出护理机构，生活更加独立。
米氏可导尿通道是四肢瘫痪患者膀胱管理的一种有价值的选择。清洁间歇性自行导尿使这些患者能够独立生活，并有助于他们回归护理机构以外的正常生活。
